
<!--MAIN CONTENT AREA-->

<div class="content-box-style">
<span class="pageTitle">Account: </span><span class="pagetitlegrey">Information</span>
<div id="etContent">

<form id="submitForm" action="/get-support/submit-ticket.html" method="post" name="submitForm" enctype="multipart/form-data">

<table class="contentpaneopen">
    <tbody><tr>
            <td><label for="submit_email"><span class="hasTip">Your email</span></label></td>
            <td><input name="email" id="submit_email" size="40" class="inputbox" type="text"></td>
        </tr>
        <tr>
            <td><label for="submit_name"><span class="hasTip">Your name</span></label></td>
            <td><input name="name" id="submit_name" size="40" class="inputbox" type="text"></td>
        </tr>
        <tr>
            <td><label for="submit_department"><span class="hasTip">Department</span></label></td>
            <td><select name="department_id" id="department_id" onchange="rst_show_custom_fields(this.value); rst_show_priority(this.value); rst_show_upload(this.value);"><option value="">Please select the department.</option><option value="3" selected="selected">Tech Support</option></select></td>
        </tr>
        <tr>
            <td>Current Employer:</td>
            <td><input name="employer" id="submit_employer" size="40" class="inputbox" type="text"></td>
        </tr>
        <tr>
            <td>Specify Occupation:</td>
            <td><input name="submit_occupation" id="submit_occupation" size="40" class="inputbox" type="text" /></td>
        </tr>
        <tr>
            <td colspan="2" width="100">
                <button type="submit" name="Submit" class="button">Submit</button>
            </td>
        </tr>
    </tbody></table>
    <p>&nbsp;</p>
    <p>
    <input name="option" value="com_rsticketspro" type="hidden">
    <input name="view" value="submit" type="hidden">
    <input name="task" value="submit" type="hidden">
    </p>
</form>

</div>
<!-- END: zone -->